SK8-1-4 Park 18+ Liability Waiver

Liability Forms

You MUST fill out a liability form if you are riding at Support the Local Grind SK8-1-4 Action Sports Park.
Name:

First NameLast Name
Age:

17 and Under Liability Form

If you are under the age of 18 a parent MUST fill this out for you.
Date:*

MonthDayYear
Minors Full Name:*

First NameLast Name
Email Address For Conformation*
Parent/Guardian Signature(s)*

Clear
Parent/Guardian Signature(s)

Clear
Name of Parent/Guardian(s)*

First NameLast Name
Name of Parent/Guardian

First NameLast Name
Drivers License Number(s)
Drivers License Number(s)
Issuing State:
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:*

Area CodePhone Number
EMERGENCY CONTACT NAME:*

First NameLast Name
EMERGENCY CONTACT PHONE NUMBER:*

Area CodePhone Number
This instrument has been signed and sworn before me by the Parent/Guardian,
Parent/Guardian Name*

First NameLast Name
This instrument has been signed and sworn before me by the Parent/Guardian on...
Date:*

MonthDayYear

18 and Up Liability Form
If you are 18 and up please take the time now to fill out this liability waiver for the Support the Local Grind SK8-1-4 Action Sports Park.
Date*

MonthDayYear
Signature of Participant*

Clear
Full Name*

PrefixFirst NameLast Name
Date of Birth*

MonthDayYear
Drivers License Number(s)
Issuing State
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number(s)*

Area CodePhone Number
EMERGENCY CONTACT NAME*

First NameLast Name
EMERGENCY CONTACT PHONE NUMBER*

Area CodePhone Number
Should be Empty:

Liability Forms